Duration of gluten exposure in adult coeliac disease does not correlate with the risk for autoimmune disorders

Guidetti, Clotilde; Solerio, E.; Scaglione, Nadia; Aimo, Giuseppe; Mengozzi, Giulio

doi:10.1136/gut.49.4.502

Cited by 210 publications

(147 citation statements)

References 21 publications

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“…In contrast with this latter finding, it has been reported that the prevalence of autoimmune diseases in patients with coeliac disease is correlated with the time of gluten exposure [12], although conflicting results have been recently reported in adults [13]. Both Type I diabetes and the other autoimmune diseases in Group A patients occurred about 4 years after the start of GFD.…”

Section: Discussioncontrasting

confidence: 41%

Severe clinical onset of diabetes and increased prevalence of other autoimmune diseases in children with coeliac disease diagnosed before diabetes mellitus

et al. 2002

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Aims/hypothesis. To analyse whether the time of diagnosis of coeliac disease with respect to the clinical onset of diabetes could differentiate subgroups of varying severity in patients with both diseases.\ud \ud Methods. We investigated 383 patients with Type I (insulin-dependent) diabetes mellitus for coeliac disease. Sex distribution, age at diagnosis of diabetes, prevalence of ketoacidosis at the onset of diabetes and prevalence of other autoimmune diseases were compared in patients. We divided these patients according to whether coeliac disease was diagnosed before (Group A, n=8) or after (Group B, n=24) diabetes onset and whether they had presented clinical symptoms of coeliac disease. Group C (n=351) included diabetic patients without coeliac disease.\ud \ud Results. Out of 383 Type I diabetic patients we found 32 coeliac subjects (8.3%). There was a higher number of girls (p=0.003), but similar age and prevalence of ketoacidosis compared with Group C; 18.7% had a third autoimmune disorder. The higher number of girls was confirmed in Groups A and B in comparison to Group C (p=0.013), while higher prevalence of both ketoacidosis (p=0.009) and other autoimmune diseases (p=0.001) was found only in Group A. Compared with symptomatic patients, asymptomatic subjects in Group B had a lower number of girls, older age at diabetes onset, lower prevalence of ketoacidosis and no other associated autoimmune disease.\ud \ud Conclusions/interpretation. A wide clinical spectrum characterises the association of coeliac disease and diabetes mellitus, with a severe clinical presentation (higher prevalence of ketoacidosis at the onset and occurrence of other autoimmune diseases) when coeliac disease is diagnosed before diabetes. Distinct phenotypes might imply the contribution of a peculiar genetic background

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Section: Discussioncontrasting

confidence: 41%

Severe clinical onset of diabetes and increased prevalence of other autoimmune diseases in children with coeliac disease diagnosed before diabetes mellitus

et al. 2002

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“…17 An increased prevalence (63%) of coexisting autoimmune conditions was noted in our patients, which is higher than the prevalence reported in celiac disease patients (5-30%). 37,38 This might explain the more pronounced skew in gender distribution, that is, female predominance observed in our series. An association with microscopic colitis, lymphocytic gastritis and/or collagenous gastritis was also seen, the former being more common and occurring at a higher frequency compared with celiac disease patients in general.…”

Section: Discussionmentioning

confidence: 63%

Collagenous sprue is not always associated with dismal outcomes: a clinicopathological study of 19 patients

et al. 2010

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Collagenous sprue is associated with high morbidity; however, the etiology of this disorder is unclear. Data regarding the pathological and clinical manifestations of patients with collagenous sprue are also limited. We, thus, undertook this study to gain insight into the etiology, disease manifestations and outcomes of collagenous sprue. We searched our departmental database (1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008) to identify cases of collagenous sprue and to obtain clinical and laboratory data. Small bowel histology, including thickness of subepithelial collagen, intra-epithelial lymphocyte phenotype and results of T-cell clonality assays were evaluated. Nineteen patients (15 women, 4 men, age 22-80 years, mean 57 years) were identified.

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“…Follow-up studies addressing the length of gluten exposure as a predictor of autoimmune disease by Sategna-Guidetti et al and Biagi et al did not confirm these findings however. [12,13] Cataldo and Marino showed higher prevalence of autoimmune disease (4.8%) among first degree relatives of celiac patients as compared to first degree relatives of healthy controls (0.86%). [14] The authors diagnosed a subset of these first degree relatives of CD patients with silent CD; a higher prevalence of autoimmune disease among this group was found as compared to healthy first degree relatives of CD patients, 20% vs. 3.8% respectively.…”

Section: Risk Of Autoimmune Diseasementioning

confidence: 91%

Celiac Disease and Autoimmunity in the Gut and Elsewhere

Barton

Murray

2008

Gastroenterology Clinics of North America

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Duration of gluten exposure in adult coeliac disease does not correlate with the risk for autoimmune disorders

Cited by 210 publications

References 21 publications

Severe clinical onset of diabetes and increased prevalence of other autoimmune diseases in children with coeliac disease diagnosed before diabetes mellitus

Severe clinical onset of diabetes and increased prevalence of other autoimmune diseases in children with coeliac disease diagnosed before diabetes mellitus

Collagenous sprue is not always associated with dismal outcomes: a clinicopathological study of 19 patients

Celiac Disease and Autoimmunity in the Gut and Elsewhere

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